Cities suffering water scarcity are projected to increase in the following decades. However, the application of standardized indicator frameworks for assessing urban water resource management problems is on an early stage. India is expected to have the highest urban population facing water scarcity in the world by 2050. In this study, the authors assess how the Drivers-Pressures-States-Impacts-Responses framework, a causal framework adopted by the European Environment Agency, can contribute to evaluate water management challenges in cities and apply it to Chennai, India´s fourth-largest urban agglomeration. The framework proved to be a helpful tool for the evaluation of water management challenges in cities by disentangling relationships between environmental indicators and structuring dispersed data that allows a better understanding for policymakers. The main drivers identified in Chennai were population growth and economic development which generated impacts such as loss of aquatic ecosystems, low water table, low water quality, and reduction of biodiversity and human health. As a response, better urban planning, projects for new water infrastructure, and water bodies restoration have been implemented. Nevertheless, Chennai keeps facing difficulties to achieve proper water management. The severe hit of the COVID-19 pandemic on the Indian economy and its future management will be key for achievements related to water management.

The purpose of this study was to establish the normative data of horizontal visible iris diameter (HVID), vertical visible iris diameter (VVID), and palpebral fissure height (PFH) in a cohort of South Indian children. The study included 1,234 children from six schools of different regions of Tamil Nadu state, India. HVID, VVID, and PFH were measured using a simple millimeter ruler by three optometrists. Based on their age, the children were divided into three groups: preprimary school children (4-5 years), primary school children (6-10 years), and high school children (11-15 years). Mean age was 4.49 ± 0.50 years, 8.00 ± 1.41 years, and 12.87 ± 1.42 years in the three groups, respectively. Mean HVID was 10.45 mm, 10.54 mm, and 10.73 mm, respectively. Mean VVID was 9.18 mm, 9.32 mm, and 9.57 mm, respectively. Similarly, mean PFH was 8.15 mm, 8.30 mm, and 8.52 mm, respectively. There was a significant difference in HVID, VVID, and PFH among the three age groups (P ≤ 0.001), as well as among male and female children in the 6-10 years age group (P ≤ 0.05) but not in the other groups. Intraclass correlation coefficient values (0.78-0.95) show good agreement among the three optometrists for all parameters. The normal range of HVID, VVID, and PFH presented in the current study can help practitioners in the diagnosis of corneal disorders, serve as a basis for the design of contact lenses, and enable accurate intraocular lens power calculations for South Indian children.

This research examines whether the groundwater in the Sivakasi Region of South India is suitable for consumption, and assesses the possible health hazards for various age demographics including infants, children, teenagers, and adults. A total of 77 groundwater samples were gathered, covering a total area of 580 km2 and analyzed for major and minor ions. The hydrogen ion concentration (pH) of the samples indicates neutral to marginally alkaline. The total dissolved solids (TDS) fluctuate from 255 to 2701 mg/l and electrical conductivity varies from 364 to 3540 µS/cm. A wide range of fluoride concentration was detected (0.1 to 3.2 mg/l) with nearly 38% groundwater samples surpassing the proposed limit (1.5 mg/l) suggested by the World Health Organization in 2017. Gibbs plot analysis suggested that most of the samples were influenced by geogenic factors, primarily rock weathering in this region. Correlation analysis showed that most of the samples were impacted by both natural and human sources. The pollution index of groundwater (PIG) fluctuated from 0.67 to 2.60 with approximately 30% and 53% of samples falling into insignificant and low pollution categories, respectively. Furthermore, 10% and 5% of total samples were characterized as moderate and high pollution levels, and 2% as very high pollution category. Spatial analysis using GIS revealed that 440.63 km2 were within safe fluoride levels according to the WHO standards, while 139.32 km2 were identified as risk zone. The principal component analysis (PCA1) showed strong positive loadings on EC (0.994), TDS (0.905), Mg2+ (0.910), Cl- (0.903) and HCO3- (0.923) indicating rock water interaction. PCA2 accounts the high positive factor loading on HCO3- (0.864) indicating ion exchange and mineral leaching. The PCA1 and PCA2 indicated that variables such as mineral leaching and rock water interaction are the major mechanisms contributing to the chemical signatures in groundwater, which may support for the elevated fluoride levels in certain areas. Risk assessments, including Hazard Quotient results showed that 71%, 61% 38%, and 34% of groundwater samples exceeded the permissible THI limit (THI > 1) for infants, children, teenagers, and adults, respectively. The study recommends implementing measures such as denitrification, defluorination, rainwater harvesting, and improved sanitation infrastructure to enhance the health conditions in the study region. Additionally, it suggests introducing educational programs in rural areas to create awareness about the health dangers due to consumption of water with high fluoride levels.

Aim: The aim of the present study is to develop a liquid chromatography-mass spectrometry method to measure two important biomarkers of biotin deficiency from dried blood spot samples for effective management of the disorder. Materials & methods: The method was developed on a liquid chromatography-mass spectrometry system using pentafluorophenyl column employing a mobile phase composition of methanol and water in the isocratic mode. A full validation of the method was performed as per relevant guidelines. Results & conclusion: Correlation between the results of dried blood spot and plasma method was evaluated to determine the interconvertibility of the method. The developed method was successfully applied for establishing the reference ranges for these biomarkers in the population of Udupi, a coastal district of South India.
Biotin deficiency can lead to many complications such as impaired growth, compromised immune function, depression, myalgia and may even lead to death. The disorder can be managed by supplementation of biotin. Early detection is crucial in managing biotin deficiency. In this paper we describe a comprehensive method for the early detection of biotin deficiency. The method employs the use of minimally invasive blood sampling such as dried blood spot that is suitable for vulnerable neonatal population.

BACKGROUND: Understanding the various principles in physiology is very important for medical students to apply their knowledge in clinical practice. Most of the students learn physiology just to clear exams. There is a need to understand the student\'s perception on the significance of learning physiology in medical colleges, its role in clinical practice, research, and the subject of career choice.
METHODS: A descriptive cross-sectional questionnaire-based study was conducted in a medical college in Karnataka, India. A total of 100 medical students studying in year 2 MBBS were enrolled into the study. Responses were collected, validated, and analyzed to understand the perception.
RESULTS: All the participants (100%) felt physiology is an important subject in the medical curriculum and 93% of participants felt physiology knowledge was essential to become a better doctor. It was observed that 48% of the participants were interested in pursuing research in physiology and only 24% of the participants agreed on considering physiology as a carrier option.
CONCLUSIONS: Medical students perceived physiology as an important and interesting subject in the medical curriculum. However, only few of the students were inclined to do research in physiology and agreed on pursuing physiology as a carrier option. The scope of study in physiology is vast due to the large variety of interdisciplinary topics included in different systems. Subsequent decrease in job opportunity, lack of awareness of research opportunities, and lower pay scale in the medical colleges in India lead to less interest in students for considering physiology as a carrier option.

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UNASSIGNED: Women in India experience high rates of postpartum depression (PPD), with minimal availability of screening or treatment. India has an extensive network of community health workers, known as accredited social health activists (ASHAs). While they are knowledgeable about most maternal-child health problems, they have minimal knowledge about PPD. We trained ASHAs to deliver a simple home-based intervention, behavioral activation (BA), which involves individuals in activities that are sources of positive reinforcement to counter depression. The research questions guiding this study were as follows: 1) What are the feasibility and acceptability of ASHAs screening for and delivering a brief behavioral activation intervention addressing PPD among women in Belagavi, South India? 2) What impact did the brief behavioral activation intervention have on PPD?
UNASSIGNED: The mixed methods evaluation used interviews with participants and interventionists, and depression scores were assessed before and after the evaluation. After a 2-day training with 17 ASHAs that focused on understanding PPD, screening using the Edinburgh Postnatal Depression Scale (EPDS), and implementing the BA protocol, ASHAs and researcher supervisors screened the mothers 6-12 weeks postpartum presenting at pediatric immunization clinics. Mothers who screened positive were invited to participate in an ASHA-led 5-week BA intervention, with ASHAs visiting the mothers\' homes. We assessed post-intervention EPDS scores and conducted satisfaction assessments and individual interviews.
UNASSIGNED: All 26 women who screened positive on the EPDS agreed to be enrolled in the study. All participants had a significant reduction (p < 0.001) in PPD scores. Both ASHAs and mothers had high enthusiasm for the intervention methods and activities.
UNASSIGNED: This ASHA-delivered BA intervention was found to be feasible, acceptable, and effective in treating PPD in rural Indian mothers. This corroborates literature that demonstrates the efficacy of a BA intervention among individuals with generalized depression in South Asia. In communities with minimal mental health resources, interventions led by trained community workers have the potential to address PPD.

Caries is a multifactorial disease that involves a majority of the pediatric population. If not diagnosed and treated, it can lead to severe consequences affecting the permanent dentition. The objective of this study was to assess the prevalence of oral foci of infection in a multispeciality hospital during the pandemic in Chennai, South India. The majority of the patients examined had caries.
Karies ist eine multifaktorielle Erkrankung, von der ein Großteil der pädiatrischen Bevölkerung betroffen ist. Wenn sie nicht diagnostiziert und behandelt wird, kann sie schwerwiegende Folgen für das bleibende Gebiss haben. Ziel dieser Studie ist es, die Prävalenz oraler Infektionsherde in einem multidisziplinären Krankenhaus während der Pandemie in Chennai, Südindien, zu untersuchen. Die Mehrheit der untersuchten Patienten hatte Zahnkaries.

Considerable advances in the diagnosis and treatment of cancer have made a huge impact on morbidity and mortality from neoplastic diseases. However, cancer remains the leading cause of death across the world. This is a retrospective study carried out at a tertiary cancer care centre (Kidwai Memorial Institute of Oncology, Bangalore) in South India. Case records of all cancer patients who died while receiving inpatient treatment between January 2022 and December 2022 under the Department of Medical Oncology were reviewed and studied. There was a total of 240 deaths. Out of these, the majority of deaths 147 (61.25%) were patients with haematological malignancies while the remaining 93 (38.75%) were patients with solid tumours. In patients with solid tumours, the majority 49 (52.7%) were in the age group of 40 to 60 years while only 18 (19.35%) patients were less than 40 years. The majority of patients were male sex i.e. 55(59.1%) and undergoing treatment with palliative intent 81 (87%). The most common organ was the lung in 21 patients (22.6%) followed by the breast while the most common system involved was the gastrointestinal tract in 28 (30.1%) patients. The most frequent cause of death was progressive disease in 72 (77.4%) while sepsis (11 patients; 11.8%) was the second most frequent cause of death in solid tumours. In haematological malignancies, also a significant number of 57 (38.8%) patients were in the age group of 40 to 60 years. Fifty-two (35.3%) patients were in the age group of 22 to 40 years. The majority were male sex (79 patients; 53.7%). About the phase of treatment, the majority of deaths 45 (30.6%) were during induction and under evaluation. Those with relapse/refractory disease were 38 (25.9%). A substantial number of patients had acute myeloid leukaemia 47 (32%) and five (3.4%) deaths were acute promyelocytic leukaemia patients. Twenty-three patients (15.6%) had acute lymphoblastic leukaemia. The most common cause of death was sepsis in 76 patients (51.7%) while intracranial bleeding was in 34 patients (23.1%). In some patients, there were multiple causes leading to death. Mortality audits are important to evaluate the services being provided at any centre. One can appreciate the lacunae in handling a particular disease or flaws in a treatment protocol or the staff delivering the treatment. Sepsis is the leading cause of death in patients with haematological malignancy; even in solid malignancy sepsis accounts for a substantial proportion of deaths and should be handled aggressively to save lives.

UNASSIGNED: Dengue is an emerging global viral disease with an increase 30-fold in incidence in the past fifty years. In the past decade it was restricted to only few a states of South and Northern India but in the recent past it has affected almost all the states in India. The objective of this study was to assess the clinical profile, trends and outcome of dengue cases.
UNASSIGNED: This retrospective record based cross-sectional study was conducted in tertiary hospital, Mangaluru in Southern India. The study population included all dengue positive cases diagnosed either by IgM Capture ELISA or Dengue Non-structural Protein NS1 antigen over a period of five years. Information from pre-recorded case sheets were used for data collection. The data was analyzed using SPSS Version 20. Results from the analysis have been expressed in percentages, means and graphs.
UNASSIGNED: The study included 401 dengue cases. Most cases were in the age range of 20-40 years with a male to female ratio of 3:2. Overall seropositivity rate was 23.94% with High IgM prevalence. Monthly distribution showed a maximum cases were in the months of June and July and minimum were in January and February. Among the study participants, 91.5% of patients recovered completely and 1.7% of patients had died. 6.8% of patients were discharged against medical advice.
UNASSIGNED: Dengue continues to be major public health problem in this part of the globe affecting mainly the working age group. Low seropositivity with High IgM prevelance makes dengue an important differential for febrile illness of vague nature and invokes the need for robust public health response to curb the hyper-endemicity.